The inspection took place on 18 January 2017 and was unannounced.

20 Towngate East provides accommodation and care for eight people who have a learning disability. There were seven people living in the service at the time of our inspection, most of whom had special communication needs. They used a combination of words, signs and gestures to express themselves.

There was a registered manager for the home. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The Care Quality Commission is required by law to monitor how a provider applies the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way. This is usually to protect themselves. The registered manager had ensured people’s rights under the MCA were protected. People were enabled to make as many decisions as possible as staff ensured they were given information in a way they understood and were given time to make their decision.

People’s individual methods of communication were identified and recorded in their care plans. This ensured that staff were able to understand people’s needs. Where people’s communication skills were limited help and advice was sought from appropriate professionals which enabled them to be involved in choices about their care.

There were enough staff available to meet people’s needs and staffing hours were flexible to fit in with people’s chosen activities and outings. Staff received an appropriate induction and ongoing training. In addition they were supported by regular supervisions and appraisals where they were able to raise any concerns and discuss their work performance.

Risks to people were identified and care was planned to keep people safe. This included risks around storage and availability of people’s medicines and people’s ability to eat safely and maintain a healthy weight.

People received person centred care which met their needs and supported them to access the activities of their choice. People’s relationships with their families and friends were identified as important to them and staff helped them maintain these relationships.

The provider and registered manager had gathered the views of people living at the home, their relatives and professionals who visited the home to help them monitor the quality of care provided and to identify areas for improvement. There were effective audits in place to monitor the safety and quality of care provided and the registered manager to action to address any concerns identified and to keep up to date with guidance and legislation. In addition the registered manager and provider had taken action regarding the concerns identified in our last report and as a result had improved their rating to good.

This was an announced inspection carried out on 3 March 2016.

20 Towngate East can provide accommodation and care for eight people who have a learning disability. There were eight people living in the service at the time of our inspection most of whom had special communication needs. They used a combination of words, signs and gestures to express themselves.

There was a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People had not always been helped to avoid the risk of accidents. Staff knew how to respond to any concerns that might arise so that people were kept safe from abuse and medicines were managed safely. There were enough staff on duty and background checks had been completed before new staff were appointed.

Staff had received training and guidance and they knew how to care for people in the right way including how to respond to people who had special communication needs. People had been supported to receive all of the healthcare assistance they needed.

Staff had ensured that people’s rights were respected by helping them to make decisions for themselves. The Care Quality Commission is required by law to monitor how registered persons apply the Deprivation of Liberty Safeguards under the Mental Capacity Act 2005 and to report on what we find. These safeguards protect people when they are not able to make decisions for themselves and it is necessary to deprive them of their liberty in order to keep them safe. In relation to this, the registered manager had worked with the relevant local authorities to ensure that people only received lawful care that respected their rights.

People were treated with kindness and compassion. Staff recognised people’s right to privacy, respected confidential information and promoted people’s dignity.

People had received all of the care they needed including people who could become distressed. People had been consulted about the care they wanted to receive and staff had supported people to pursue a wide range of interests and hobbies. There was a system for resolving complaints.

Quality checks had not always ensured that problems in the running of the service were quickly resolved. Staff were supported to speak out if they had any concerns because the service was run in an open and inclusive way. People had benefited from staff acting upon good practice guidance.

We spoke with two people who lived at the home, but due to their needs we were not able to have long conversations with them. In response to our question, "Do you like living here," one person replied, "Yes I do." We observed the care and attention that all the people received from staff. All of the interactions we saw were appropriate, respectful, encouraging and friendly. Staff respected peoples' dignity.

The accommodation was designed and adapted to meet the needs of the people living there and had recently been extended and refurbished, ensuring it was properly suited to caring for people with limited mobility. Risks to people living in the home had been assessed. The home was warm, clean and was personalised to the people who lived there.

We saw that people's support plans and risk assessments reflected their needs and were up to date. Staff we spoke with were aware of the contents of the support plans, which enabled them to deliver appropriate and safe care. The provider had systems in place that ensured the safe receipt, storage, administration and recording of medicines. Staff recruitment systems were robust.

20 Towngate East provides care for seven people with learning disabilities or autistic spectrum disorder. Some of the people were unable to talk to us so we spent some time observing the care they received. We saw there was a positive interaction between the people who lived at the home and the care staff. Where people were unable to communicate verbally we saw staff were quick to pick up on people’s non verbal communication to provide the care and support needed.

Records showed people were encouraged to be active and be a part of the local community. People were able to engage in a wide range of activities.

The home was clean and tidy and we saw there were systems in place to maintain the cleanliness. This was audited by the manager.

On the day we visited, five of the seven residents were out at day centres or participating in activities of their choice. We spoke with one of the residents who told us that he liked living in the home and was happy. He said he liked watching television, getting visitors and liked going out to buy clothes.